What Are the Side Effects of Prescription Sleeping Pills?

Van Winkle's
A new website dedicated to smarter sleep & wakefulness, published by Casper.

Side effects have bedeviled prescription sleep medications since scientists began tinkering in their labs more than a century ago.

Chloral hydrate, a derivative of ethyl alcohol, was first introduced in 1869 as a sedative-hypnotic. It was the primary ingredient of so-called knockout drops, which did what the nickname suggests: They knocked people unconscious, making them popular with criminals. But besides the side effect of parting you from your money, chloral hydrate could also put you in a stupor — and even kill you in five to 10 hours.

The first generation of modern sleeping pills, barbiturates, hit the U.S. market in the early 1900s. They had their own serious consequences, two of which were addiction and overdosing. Next came the benzodiazepines, known by the brand names Valium, Halcion, Dalmane, Ativan, Xanax and Klonopin. They are largely prescribed for anti-anxiety, but their sleepy side effects have made them America’s favorite prescription sleeping pill.

But easy benzo sleep comes at a price. Besides being highly addictive, a recent study linked benzos with Alzheimer’s.

We’re now on our third generation of sleep aids, all of which still come with side effects and warnings in their packaging material. But that shouldn’t surprised anyone — sleeping pills work by sedating your central nervous system in one way or another. They may inhibit or block neurotransmitters, slow down breathing, and trick your tired body into sleep.

What are some risks of the newer sleep meds?

The newest class of sleep medications, non-benzodiazepines, also called Z-drugs, can help alleviate insomnia with fewer side effects than their benzo predecessors. But they still have them. Known by their brand names Ambien, Ambien CR, Lunesta, Sonata and Rozerem, they’re considered safer. But they’re still recommended for short term use; they, too, too can become addictive.

The most notorious side effects of Ambien were reports of patients engaging in bizarre behaviors like driving, making phone calls, having sex or gorging on candy bars — while more or less asleep — then having no memory of their activities the next day. These cases are rare (about one percent of patients), but noteworthy.

Equally rare, but still disconcerting are the one percent of patients who have suicidal thoughts, or an uptick in aggressive behavior. This is a particular risk if the patient is depressed. The FDA recently recommended lowering the dosage from 10 milligrams (mg) to five mg, especially for women, whose bodies eliminate the active ingredient, zolpidem, more slowly than men.

Ambien CR (zolpidem tartrate)

This longer-acting Ambien releases zolpidem into your bloodstream continuously throughout the night; it was designed to help people stay asleep.

Morning grogginess and lower alertness may seem like the least worrisome of all sleep medicine side effects — prescription or otherwise. But this becomes a public health hazard if you drive a car, pilot a plane or operate some other type of transportation or heavy machinery.

As always, make sure your doctor knows about your daily life and how any medication can affect it.